1. Field of the Invention
The present invention relates to surgical instruments and, particularly, to an instrument with a rotatable distal end. Still more particularly, the present invention relates to an endoscopic instrument, such as scissors or a biopsy forceps device, with a rotatable distal end.
2. Background of Related Art
During many medical procedures, surgical instruments are commonly used in conjunction with other devices such as endoscopes, catheters, cannulas, and trocars. Typically, those devices provide the passageway for entry of the surgical instrument into the body. For example, a surgical procedure, such as biopsy tissue sampling, is often performed with an endoscope and an endoscopic surgical instrument within the endoscope. An endoscope is a long flexible tube carrying fiber optics. The fiber optics aid the physician in manipulating the endoscope to a site within the body and allow the physician to view that site during the procedure. The endoscope also has a lumen through which a surgical instrument may be inserted to perform some procedure at the body site. In the case of a biopsy, the surgical instrument is called a bioptome.
A bioptome typically includes a long flexible coil having a control wire extending therethrough. At its distal end, the bioptome has a pair of opposed jaws, while at its proximal end it has a manual actuator to actuate the jaws. Manipulation of the actuator opens and closes the jaws.
In order to take a biopsy tissue sample, the physician guides the endoscope to the biopsy site through a body lumen while viewing the passage of the endoscope and the biopsy site through the fiber optics. The bioptome is then inserted through the lumen of the endoscope until the jaws arrive at the biopsy site. While viewing the biopsy site, the physician positions the jaws around the tissue to be sampled and manipulates the actuator so that the jaws close around the tissue. A tissue sample is then cut or torn away from the surrounding tissue and trapped within the jaws of the bioptome. Keeping the jaws closed, the surgeon withdraws the bioptome from the endoscope and then opens the jaws to collect the biopsy tissue sample. If multiple tissue samples are desired a multiple sample bioptome, such as shown in U.S. Pat. No. 5,542,432, may be used.
During this sampling procedure, the desired tissue site may be difficult to reach or the jaws may arrive at the biopsy site in an unsuitable position or orientation for taking the desired tissue sample. The latter may occur because the jaws of the bioptome are not freely rotatable. In many bioptomes, torque applied at the proximal end of the bioptome does not translate into rotation of the jaws. Often, excessive manipulation of the endoscope is required to achieve any rotation of the jaws. Such manipulation can cause trauma to the patient.
Likewise, with many other surgical instrument tools, such as, for example, scissor blades, graspers, suture graspers, tissue manipulators, and forceps, torque applied at the proximal end of the instrument does not translate into rotation of the tool. Again, excessive manipulation of the instrument may be required to achieve any rotation of the tool causing trauma to the patient.